Progress in Chronic Disease Prevention
Chronic Disease Reports: Deaths from
Diabetes -- United States, 1986
In 1986, diabetes (International Classification of Diseases, Ninth
Revision, Clinical Modification (ICD-9-CM) 250) was listed as the
underlying cause of death for 37,178 persons in the United States.
Diabetes mortality rates (age-standardized to the 1986 U.S.
population)
were lowest in Nevada (11.6 per 100,000) and highest in Delaware
(26.3
per 100,000) (Figure 1, Table 1).
Diabetes-related deaths accounted for 1.8% of U.S. mortality and
for
1% of years of potential life lost before age 65 (1). However,
diabetes
was mentioned as a con tributory cause of death on 4.1 times as
many
death certificates as it was selected as the underlying cause
(Table
2). Moreover, diabetes was not listed on approximately half of
death
certificates for persons with noninsulin-dependent diabetes (2).
Thus,
diabetes may be associated with approximately eight times as many
deaths as indicated by underlying cause alone.
Rates of diabetes mortality declined in the 1970s, but the decline
has
slowed in recent years (3). Rates of diabetes mortality increase
with
age, are 6% higher in males than in females and 39% higher in
nonwhites
than in whites (4). Smoking, hypertension, and overweight are
modifiable risk factors for death among diabetic persons (Table 2);
estimates of deaths that could be averted by eliminating these risk
factors are substantial (Table 2). Diabetes also contributes to
end-stage renal disease, amputations, blindness, and other serious
complications; associated risk factors include higher levels of
glycemia, smoking, and hypertension. Assuming that risk-factor
reduction among diabetic persons would have the same benefit as in
the
general population, more effective control of smoking,
hypertension,
and overweight should further decrease morbidity and mortality
rates
among diabetic persons.
Reported by: Div of Surveillance and Epidemiologic Studies,
Epidemiology Program Office; Div of Diabetes Translation, Center
for
Chronic Disease Prevention and Health Promotion, CDC.
References
CDC. Years of potential life lost before age 65--United States,
1987. MMWR 1989;38:27-9.
Herman WH, Teutsch SM, Geiss LS. Closing the gap: the problem of
diabetes mellitus in the United States. Diabetes Care
1985;8:391-406.
CDC. Trends in diabetes mellitus mortality. MMWR 1988;37:769-73.
NCHS. Vital statistics of the United States, 1986. Vol.
II--Mortality, pt A. Hyattsville, Maryland: US Department of Health
and
Human Services, Public Health Service, 1988; DHHS publication no.
(PHS)88-1122.
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